BITE INDUSTRY EXCHANGE AWARD SCHEME APPLICATION

To be accompanied by: short (max 4 page) CV for the secondee

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Section 1 - General
1.1 Call / BITE INDUSTRY EXCHANGE AWARD SCHEME
1.2 Project title
1.3 PI/ Academic Lead at UCL / Name / Email
1.4 UCL Department
1.5Partner Organisation / Name
Organisation type
Number of employees
Lead contact name / Email
Address
1.6 Secondee / Name / Email
1.7 Type / Delete as appropriate
Outward (to partner) / inward (to UCL)
Section 2 - Project Track Record
2.1Summary of underpinning research for secondment project
Research grant details (awarding body, reference number)
2.2 Previous knowledge exchange from project including details of any funding received
2.3 Previous engagement between UCL and Partner

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Section 3 - Planned Activities for period on secondment (at least 20% should be business-related)
3.1 List the main objectives to be carried out
3.2 List the key stages of work to be undertaken
3.3 Describe the expected benefits to thePartner organisation resulting from the activity. Quantify the benefits
3.4 Describe the expected benefits to UCL resulting from the activity including the impact on UCL’s research and teaching
3.5 Outline the benefits to the secondee resulting from participating in this activity
3.6 Outline the future plans following successful completion
3.7 Has the secondee attended the BITE Business & Entrepreneurship Training? (If so please list dates attended)

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Section 4 - Financial
4.1 Proposed Start Date
4.2 Proposed End Date
4.3
Directly incurred costs requested (£) / Consumables (not for research materials) / Travel (for day-to-day business activities) / Total
4.4
Staff to be funded / Name / Student/Employee number / Stipend/Salary gross amount and spine point
UCL background
Delete as appropriate
Not applicable/doctoral student/PRDA/technical or support staff/teaching staff
FTE of secondment / Date from/to
4.5 Value of EPSRC IAA funding required
4.6 Describe overall expected spend profile over time
4.7Justification of resources requested
4.8Partner(s)
Contribution (£) / Direct / In kind / Total
e.g. management supervision time, training costs, materials, partner overheads.
*Please note these are not fundable
4.9Details of Contribution from Partner Organisation
4.10Cost Centre / For office use only
4.11 Departmental Administrator / Name / Email
For office use only / For office use only
Office use only
Approved by Chair of BITE Board
Panel outcome / Approved / Not Approved
Funding Source
Direct Costs Funds awarded / Salaries with oncosts
£ / Consumables and Travel
£ / Total
£
Estates and Indirects Funds awarded
Account Code
Amendments
pFACT costing number

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KNOWLEDGE EXCHANGE SECONDMENT IMPACT CAPTURE

TO BE COMPLETED AT PROJECT END

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Section 5 - General
5.1 Call / BITE INDUSTRY EXCHANGE AWARD SCHEME
5.2 Project title
5.3 PI/ Academic Lead at UCL / Name / Email
5.4 UCL Department
5.5 Partner Organisation / Name
Lead contact name
Address
5.6 Secondee / Name / Email
Section 6 - Project Track Record
6.1 Original Project Aims
6.2 Any changes made to the original aims
6.3 Detail any impact on the partner organisation’s business. as a result of the secondment i.e securing new business, generating new profit, improving knowledge and skills of partner organisation staff
6.4 Detail any impact on UCL’s research , teaching and enterprise activity a result on the secondment
6.5 Detail any impact on the secondee as a result of the secondment
6.6 List any follow on activity being undertaken

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